Incidence and risk factors of lower respiratory tract illnesses during infancy in a Mediterranean birth cohort

Abstract Background Childhood lower respiratory tract infections (LRTIs) cause substantial morbidity and under-5 child mortality. The epidemiology of LRTI is changing in low- and middle-income countries with expanding access to conjugate vaccines, yet there are few data on the incidence and risk factors for LRTI in these settings. Methods A prospective birth cohort enrolled mother–infant pairs in 2 communities near Cape Town, South Africa. Active surveillance for LRTI was performed for the first 2 years of life over 4 respiratory seasons. Comprehensive data collection of risk factors was done through 2 years of life. World Health Organization definitions were used to classify clinical LRTI and chest radiographs. Results From March 2012 to February 2017, 1143 children were enrolled and followed until 2 years of age. Thirty-two percent of children were exposed to antenatal maternal smoking; 15% were born at low birth weights. Seven hundred ninety-five LRTI events occurred in 429 children by February 2017; incidence of LRTI was 0.51 and 0.25 episodes per child-year in the first and second years of life, respectively. Human immunodeficiency virus (HIV)–exposed, uninfected infants (vs HIV-unexposed infants) were at increased risk of hospitalized LRTI in the first 6 months of life. In regression models, male sex, low birth weight, and maternal smoking were independent risk factors for both ambulatory and hospitalized LRTI; delayed or incomplete vaccination was associated with hospitalized LRTI. Conclusions LRTI incidence was high in the first year of life, with substantial morbidity. Strategies to ameliorate harmful exposures are needed to reduce LRTI burden in vulnerable populations.

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Risk Factors for Hospitalization With Lower Respiratory Tract Infections in Children in Rural Alaska

PEDIATRICS ◽

10.1542/peds.2011-1943d ◽

2012 ◽

Vol 129 (5) ◽

pp. X30-X30

Keyword(s):

Risk Factors ◽

Respiratory Tract ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Lower Respiratory Tract Infections ◽

Rural Alaska ◽

Tract Infections

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Viral Quantification of Human Rhinovirus Using Digital RT-PCR in Lower Respiratory Tract Samples From Hematopoietic Cell Transplant Recipients: Risk Factors Determining Viral Load and Association with Mortality

Biology of Blood and Marrow Transplantation ◽

10.1016/j.bbmt.2017.12.469 ◽

2018 ◽

Vol 24 (3) ◽

pp. S381-S382

Author(s):

Alpana Waghmare ◽

Hu Xie ◽

Thuy Nguyen ◽

Terry L. Stevens-Ayers ◽

Wendy M. Leisenring ◽

...

Keyword(s):

Risk Factors ◽

Viral Load ◽

Respiratory Tract ◽

Lower Respiratory Tract ◽

Hematopoietic Cell ◽

Human Rhinovirus ◽

Cell Transplant ◽

Transplant Recipients ◽

Rt Pcr ◽

Hematopoietic Cell Transplant

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Risk factors for severe RSV-induced lower respiratory tract infection over four consecutive epidemics

European Journal of Pediatrics ◽

10.1007/s00431-007-0418-y ◽

2007 ◽

Vol 166 (12) ◽

pp. 1267-1272 ◽

Cited By ~ 55

Author(s):

Giovanni A. Rossi ◽

Maria Cristina Medici ◽

Maria Cristina Arcangeletti ◽

Marcello Lanari ◽

Rocco Merolla ◽

...

Keyword(s):

Risk Factors ◽

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract Infection ◽

Lower Respiratory Tract

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Lower respiratory tract infections in early life are associated with obstructive sleep apnea diagnosis during childhood in a large birth cohort

SLEEP ◽

10.1093/sleep/zsab198 ◽

2021 ◽

Author(s):

Maria J Gutierrez ◽

Gustavo Nino ◽

Jeremy S Landeo-Gutierrez ◽

Miriam R Weiss ◽

Diego A Preciado ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Respiratory Tract ◽

Birth Cohort ◽

Early Life ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Lower Respiratory Tract Infections ◽

Obstructive Sleep ◽

Tract Infections

Abstract Study Objectives Several birth cohorts have defined the pivotal role of early lower respiratory tract infections (LRTI) in the inception of pediatric respiratory conditions. However, the association between early LRTI and the development of obstructive sleep apnea (OSA) in children has not been established. Methods To investigate whether early LRTIs increase the risk of pediatric OSA, we analyzed clinical data in children followed during the first 5 years in the Boston Birth Cohort (n = 3114). Kaplan–Meier survival estimates and Cox proportional hazards models adjusted by pertinent covariates were used to evaluate the risk of OSA by the age of 5 years between children with LRTI during the first 2 years of life in comparison to those without LRTI during this period. Results Early life LRTI increased the risk of pediatric OSA independently of other pertinent covariates and risk factors (hazard ratio, 1.53; 95% CI, 1.15 to 2.05). Importantly, the association between LRTI and pediatric OSA was limited to LRTIs occurring during the first 2 years of life. Complementarily to this finding, we observed that children who had severe respiratory syncytial virus bronchiolitis during infancy had two times higher odds of OSA at 5 years in comparison with children without this exposure (odds ratio, 2.09; 95% CI, 1.12 to 3.88). Conclusions Children with severe LRTIs in early life have significantly increased risk of developing OSA during the first 5 years of life. Our results offer a new paradigm for investigating novel mechanisms and interventions targeting the early pathogenesis of OSA in the pediatric population.

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Community-acquired Respiratory Viruses Are a Risk Factor for Chronic Lung Allograft Dysfunction

Clinical Infectious Diseases ◽

10.1093/cid/ciy1047 ◽

2018 ◽

Vol 69 (7) ◽

pp. 1192-1197 ◽

Cited By ~ 14

Author(s):

Maddalena Peghin ◽

Ibai Los-Arcos ◽

Hans H Hirsch ◽

Gemma Codina ◽

Víctor Monforte ◽

...

Keyword(s):

Infectious Disease ◽

Risk Factors ◽

Acute Rejection ◽

Respiratory Tract ◽

Lower Respiratory Tract ◽

Lung Transplant ◽

Respiratory Viruses ◽

Transplant Recipients ◽

Independent Risk Factors ◽

Lung Transplant Recipients

Abstract Background The relationship between community-acquired respiratory viruses (CARVs) and chronic lung allograft dysfunction (CLAD) in lung transplant recipients is still controversial. Methods We performed a prospective cohort study (2009–2014) in all consecutive adult patients (≥18 years) undergoing lung transplantation in the Hospital Universitari Vall d’Hebron (Barcelona, Spain). We systematically collected nasopharyngeal swabs from asymptomatic patients during seasonal changes, from patients with upper respiratory tract infectious disease, lower respiratory tract infectious disease (LRTID), or acute rejection. Nasopharyngeal swabs were analyzed by multiplex polymerase chain reaction. Primary outcome was to evaluate the potential association of CARVs and development of CLAD. Time-dependent Cox regression models were performed to identify the independent risk factors for CLAD. Results Overall, 98 patients (67 bilateral lung transplant recipients; 63.3% male; mean age, 49.9 years) were included. Mean postoperative follow-up was 3.4 years (interquartile range [IQR], 2.5–4.0 years). Thirty-eight lung transplant recipients (38.8%) developed CLAD, in a median time of 20.4 months (IQR, 12–30.4 months). In time-controlled multivariate analysis, CARV-LRTID (hazard ratio [HR], 3.00 [95% confidence interval {CI}, 1.52–5.91]; P = .002), acute rejection (HR, 2.97 [95% CI, 1.51–5.83]; P = .002), and cytomegalovirus pneumonitis (HR, 3.76 [95% CI, 1.23–11.49]; P = .02) were independent risk factors associated with developing CLAD. Conclusions Lung transplant recipients with CARVs in the lower respiratory tract are at increased risk to develop CLAD.

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